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Testimony before the Senate and House Committees on Ways and Means Hearing Monday, March 10, 2003 on the FY04 Education BudgetTop of Page
Chairman Flynn and members of the Committee, Good afternoon.
My name is Patricia Cook. I am a Registered Nurse working as a School Nurse at the Whitman Elementary School in Brockton, Massachusetts. I received my Associates Degree from Massassoit Community College School of Nursing and my Bachelors Degree in Nursing from the University of Massachusetts, Boston Campus. I have worked as a Pediatric Office Nurse for 5 years, and am now in my fourth year of School Nursing.
I am here today to speak for the children enrolled in our schools across the State. Time today does not allow me to go into a lengthy dissertation of what School Nurses do, but if you'd like a better idea of what some of us do, there is an excellent publication called the Enhanced School Health Services Program Data Report, 2001 - 2002 School Year from the Department of Public Health, Bureau of Family and Community Health, Applied Statistics, Evaluation and Technical Services, published in February 2003. This report tells you, WHO WE ARE AND WHAT WE DO.
School nurses are not just Band-Aids and Bacitracin anymore. We are responsible for Nursing Assessment and Treatments, Health Education and Mental Health Counseling. We write injury reports, send home students who are ill, and refer others for Emergency Health Services. Some students require daily medications, while others receive their meds on an as needed basis. Annually, as required by law, we conduct postural, hearing and vision screening on our students. Their heights and weights are measured. In some cases, we check their Blood Sugars, Blood Pressures, perform Cath care, Nasogastric tube care, perform Peak Flow measurements, administer Nebulizer treatments, Tracheostomy care, Chest Physiotherapy, and the list continues.
On a personal level, I can tell you at my school, with a meager enrollment of 204, I have 49 students with special health care needs. There are students with Food Allergies, Asthma, Sickle Cell Anemia, Cardiac conditions, Migraine Headaches, Seizure Disorders, Speech Defects, Tourette Syndrome and Lupus. There are also students with Behavioral and Emotional Conditions ranging from ADHD/ADD, Depression and ODD.
Since the beginning of this school year, there has been 1,129 visits to the Health room at my school. Of the 205 students screened for Vision, 14 had to be re-screened, with all 14 being referred for further evaluation, and 8 of those students have had completed referrals.
Just last Monday, a little second grade student arrived at my office, complaining of a headache. School had just started. After a careful health assessment, I asked her about how things were going at home. She told me that her grandfather had just died on Friday. "He went to the hospital, and died." I knew this would be hard for her, because not only her grandparents live with her family, her Aunt and cousins live upstairs. We talked for a little while and she returned to class. Later that same afternoon, she returned to my office. Her eyes were red and her cheeks were mottled. She had been crying. I asked her what had happened. She told me something flew in her ear. I quickly ruled out flying insects, this being the middle of winter and all. She told me that yesterday her ear was itchy, and she told her mom. I carefully examined her left ear, the unaffected ear, which looked beautiful, but upon examination of her right ear, I observed a yellow crayon. Her Mom was phoned, and I advised a visit to her primary care physician, to have the foreign body removed. He was unable to remove it, the Ear Nose and Throat Specialist was also unable to remove it, and she had to have surgery the following morning to have it removed.
This past Friday, a third grade student came to my office with a headache. His life and that of his brother were now in turmoil, as they had recently been taken away from their parents and placed in foster care together. Knowing this, I asked him if this was the kind of headache that he needed to have medicine for, or the kind that a little rest could take care of. He answered, "A little Rest." We began to talk about how things were going in his new home, and he told me how he went to his foster brother's soccer practice, and how much he wanted to join the team. I told him that sometimes teams are already made up, but that if he wanted me to, I would speak with his case worker who picks him up from school each day, and see if there was something she could do about getting him on the team. When she arrived, we talked, I gave her a brief update on how "he" felt things were going, and asked her to look into the soccer situation for him.
School nursing is a bit more than Band-Aids and Bacitracin. School nurses across this Commonwealth "Dare to Care!"
Today when you go home, ask your children, your grandchildren, your nieces and nephews, who takes care of them when they are sick or upset at school, and when it comes time to fund the Education Budget for FY 2004, please consider the school children of the Commonwealth and ask yourself.......
"Do I Dare to Care?"
Thank-you for your time and consideration. I am now happy to entertain any questions that the committee may have.
Patricia A. Cook, RN
Brockton Public Schools
Whitman Elementary School
25 Manomet Street
Brockton, Massachusetts 02301